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Individual

STEPHANI RENAE LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
6800 S GRANITE AVE, TULSA, OK 74136-7039
(918) 491-5200
Mailing address
2905 W CANTON ST, BROKEN ARROW, OK 74012-0824
(479) 883-1120

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5553
OK

Other

Enumeration date
06/08/2021
Last updated
06/08/2021
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